Provider Demographics
NPI:1093936833
Name:SOLVANG-MOSCICKI, ELYN D (NP)
Entity Type:Individual
Prefix:
First Name:ELYN
Middle Name:D
Last Name:SOLVANG-MOSCICKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 BATAVIA CITY CTR
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-2107
Mailing Address - Country:US
Mailing Address - Phone:585-344-4444
Mailing Address - Fax:585-219-6114
Practice Address - Street 1:35 BATAVIA CITY CTR
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-2107
Practice Address - Country:US
Practice Address - Phone:585-344-4444
Practice Address - Fax:585-219-6114
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF301104-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health